erectile dysfunction or impotence Its diagnosis and treatment

Erectile Dysfunction or Impotence: Its diagnosis and treatment

What do we understand by Erectile Dysfunction?

Erectile dysfunction or impotence is the persistent inability to attain and maintain an erection sufficient to permit satisfactory physical performance.

Erectile dysfunction is a benign disorder, but it affects physical and psychosocial health and has a significant impact on the quality of life of those who suffer from it and their partners and families.

Are there risk factors that favor the early presentation of erectile dysfunction?

Among the risk habits that can lead to its development is consuming legal addictive substances: smoking, excessive or illegal alcohol (cocaine, hashish, designer drugs), and stress.

Does age matter in the presence of erectile dysfunction?

A great controversy is the association of erectile dysfunction and aging, referring to the fact that s**uality has an expiration date; what happens is that the aging process leads to a more significant refractory period, that is, the need for more time for a new erection after an orgasm.

Age also seems to affect the time it takes to get aroused and for erection and ejaculation. All of these are considered non-pathological changes.

If ED occurs more in older people, it is only because they are more likely to suffer from ED-associated diseases and to use more drugs that alter erectile function.

How do we diagnose erectile dysfunction?

1.- Clinical history

It is interesting to collect current and previous medical problems, medications taken, and a history of psychological problems (stress, anxiety, and depression). The physical history (onset of ED, frequency, quality, and duration of any erection, etc.) will be investigated, the motivation for treatment and the patient’s expectations will be assessed. ED is logically a matter of two, and it may be appropriate to interview the partner (whatever the patient’s preference).

The physical examination focuses on the genitourinary, endocrine, vascular, and neurological systems, especially evidence of other diseases (hypertension, diabetes, atherosclerosis, nerve damage, etc.), should be sought.

In the evaluation of erectile dysfunction, questionnaires are used to see the degree of affectation and repercussion. The most used are the IIEF (International Index of Erectile Function, the International Index of Erectile Function) and its simplest version: the SHIM test (physical Health Inventory for Men, that is, the physical Health Inventory for Men).

  1. – Analytical tests

Laboratory tests must be tailored to the patient’s symptoms and risk factors. All patients must perform a blood glucose determination, lipid series (cholesterol, triglycerides), and a hormonal study (testosterone; if there is a decrease in love desire: prolactin) to determine if there are endocrine system problems.

3.- Complementary examinations

They include, depending on the characteristics of the patient:

  • Ultrasound and duplex study of the organ arteries
  • Determination of nocturnal penile tumescence and stiffness
  • Injection tests into the corpora cavernosa of vasoactive substances

What is the treatment for Erectile Dysfunction?

The treatment modality is dictated by the specific problem causing erectile dysfunction. The first step is to define the cause, if possible, and then try to identify the needs and expectations of the patient to offer the most straightforward and least Fildena 100  solution.

A.- General measures

Modify lifestyle habits and risk factors: Stop smoking, moderate alcohol and fat consumption, get some exercise, and learn to relax.

Change or reduce medications that may be causing it, such as some antidepressants, diuretics, beta-blockers, and antihypertensive.

In erectile dysfunction of a psychogenic nature: Psychotherapy and behavioral therapy.

B.- Specific treatment:

An erectile dysfunction of hormonal cause: The alteration of testosterone levels will be treated by administering the same intramuscular route, lotions, or patches. Before administering testosterone, a rectal examination and determination of PSA should be done. It is contraindicated in patients with prostate cancer and with significant symptoms of prostatism.

Drugs: Oral drug therapy

These drugs’ mechanism of action consists of inhibiting the enzyme 5-phosphodiesterase, which is located in the corpus cavernosum; this causes an increase in arterial flow, which produces relaxation of smooth muscle vasodilation, and erection of the organ.

Importantly, they are not erection initiators and require physical stimulation to facilitate erection.

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